Grandfathered plans are those health insurance plan purchased prior to 2010 and still in force.

To reduce the administrative burden of maintaining multiple products/contracts, we will be discontinuing about 200 grandfathered plans/contracts, many of which only have a few members. This change will impact around 14,000 members and some of these members may have other Anthem options to replace their plans.

As of today, the specific products and contracts are unknown. I was told we should expect more information by mid-December.

For those on grandfathered plans, be aware that Anthem is only selling individual health insurance (EPO) in areas 1, 7 and 10 (Santa Clara County, Stockton area and northern Counties). Those in other rating areas will need to change insurers and find new coverage (and move to ObamaCare).

When it comes to HealthNet individual & family health plans, things can get a little tricky.

HealthNet has offered their traditional PPO plan in selected areas of California for a few years now. This PPO is a broad-network plan. In areas where it is available, the network exceeds that or competitor Blue Shield. The new EnhancedCare PPO is a smaller network PPO plan introduced in certain regions for 2018.

In 2018, HealthNet has made some changes so I want to cover them here.

Traditional PPO (off exchange only)HealthNet's traditional individual & family PPO plan for 2018 will be available in the following regions:

According to Kaiser Health News, the California Department of Managed Health Care (DMHC) has fined Anthem 5 million dollars for failure to address member grievances.

According to DMHC, between 2013 and 2016, it (DMHC) identified 245 grievance-system violations by Anthem.

Rouillard cited one example in which Anthem denied a submitted claim for an extensive surgical procedure, even though it had issued prior approval for the operation. Twenty-two calls contesting the denial — placed by the patient, the patient’s spouse, the couple’s insurance broker and the medical provider — failed to resolve the complaint. It was not until the patient sought help from the managed-care agency, more than six months after the treatment, that Anthem paid the claim.Read the full article at KHN